Active NPI
Theresa Bradshaw, BS
- Neurorehabilitation Occupational Therapist
- Louisville, KY
National Provider Identifier
1043462377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- License
- KY-R2889
- Practice address
- 401 E Chestnut St
Suite 510
Louisville, KY 40202-5700 - Phone
- (502) 589-0802
- Fax
- (502) 589-0805
- NPI assigned
- Oct 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | KY-R2889 | KY | Primary |
Addresses
Primary practice location
401 E Chestnut St
Suite 510
Louisville, KY 40202-5700
Mailing address
401 E Chestnut St
Suite 510
Louisville, KY 40202-5700
Phone (502) 589-0802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KY-R2889 | Other | KY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-R2889 | KY | MD | Neurorehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224201600000",
"number": "1043462377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E CHESTNUT ST",
"address_2": "SUITE 510",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402025700",
"telephone_number": "502-589-0802",
"fax_number": "502-589-0805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E CHESTNUT ST",
"address_2": "SUITE 510",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402025700",
"telephone_number": "502-589-0802",
"fax_number": "502-589-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "THERESA",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-17",
"last_updated": "2008-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "KY",
"license": "KY-R2889",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "KY-R2889",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.